[Reconstructive surgery of sequelae of compartment syndrome of the lower leg and/or foot. Presentation of a new classification].
The sequelae of an undiagnosed insufficiently treated or unpreventable (by crush injury) compartment or postischemic syndrome, most often after lower leg fracture or popliteal artery injury, are caused by necrosis and contracture of the extrinsic foot muscles. Therefore claw toes, pes equinus or other forms, such as a severe pes equino varus related to the compartment involved will decide the kind of foot deformity. In cases of a combined compartment syndrome of the lower leg and foot, not only the extrinsic but also the intrinsic muscles especially the short flexors are involved, leading to extensive claw toeing of the hallux and the lesser toes as well. In the case of an isolated compartment syndrome of the foot one will see contracted hammer toes most often after open or third degree closed calcaneal fractures. A new classification of all the different deformities of the foot and ankle as sequelae of a compartment and/or postischemic syndrome, is introduced distinguishing 5 degrees of deformity. Between 1994 and 2006, a total of 66 patients with sequelae of a compartment and/or postischemic syndrome were treated at the Department of Trauma and Reconstructive Surgery of the University Hospital"Carl Gustav Carus" of the Technical University of Dresden. Patients with contract hammer toes after calcaneal fractures were seen most often (n=26). Another large group of 24 patients suffered from the sequelae of a compartment and/or postischemic syndrome of the extrinsic muscles of the superficial and deeper compartment of the flexor tendons, producing a severe pes equino varus. Less common (n=16) were the deformities caused by an isolated compartment syndrome, such as necrosis of the anterior tibialis, long extensor muscles, peroneal muscles or a combined compartment syndrome of the lower leg and foot.
Zwipp
H
H
Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Dresden, Dresden, Deutschland. hans.zwipp@uniklinikum-dresden.de
D003161:Compartment Syndromes / Q000145:classification* / Q000601:surgery*; D005531:Foot Deformities, Acquired / Q000145:classification* / Q000601:surgery*; D005534:Foot Diseases / Q000145:classification* / Q000601:surgery*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome